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'A �& <br />"ARCO Products Company <br />Station # �J (2 <br />Address <br />t <br />Mechanical Leak Detector Test Data Sheet <br />Date 19 <br />Test Information <br />T <br />Replaced All Failed Leak Detectors Yes No ' ` N/A- <br />If <br />/A_If No, Replacement To Be Completed By (Date) % / / / UO <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. �}— <br />Inspected By: Contractor <br />TechnicianLic# <br />Signature <br />APC -3325 (at%) <br />I <br />1 <br />2 <br />3 <br />4 <br />5 <br />Product <br />Manufacturer, <br />_ � -_ <br />0 V`\ <br />6,1 <br />Model <br />C—r- <br />Lb 2, <br />'6, D (VO <br />Full Operating Pressure (psi) <br />2 <br />Line Bleed Back (nil) <br />65) 4— <br />Trip Time (sec) <br />JD <br />2 —3fVC <br />Metering Pressure (psi) <br />F/E Holding Pressure (psi) <br />S <br />Test Leak Rate (ml/min) (g -ph) <br />PASS or FAEL <br />T <br />Replaced All Failed Leak Detectors Yes No ' ` N/A- <br />If <br />/A_If No, Replacement To Be Completed By (Date) % / / / UO <br />This letter certifies that the annual leak detector tests were performed at the above referenced facility <br />according to the equipment manufacturers procedures and limitations and the results as listed are to my <br />knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow <br />threshold trip rate of 3 gph at 10 PSI. �}— <br />Inspected By: Contractor <br />TechnicianLic# <br />Signature <br />APC -3325 (at%) <br />I <br />